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General NPI Number Information
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NPI Number | 1982572749
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Entity Type | Organization
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Legal Business Name | WHOLESOME LIVING FACILITY LLC
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Dates
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Enumeration Date | 10/24/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 9288 BETICA AVE
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City | LAS VEGAS
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State | NV
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Zip | 89148
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Country | US
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Telephone | 702-326-6421
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Fax |
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Provider Business Mailing Address
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Address Line | 6236 PEGGOTTY AVE
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City | LAS VEGAS
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State | NV
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Zip | 89130-1312
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MS. CORTNEE SMITH
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Credential | LMSW
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Telephone | 702-268-0020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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